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AstraZeneca: A Lesson in How to Shoot Yourself in the Foot? - WSJ.com

Anonymous

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There must have been an enormous groan emitted from AstraZeneca’s London Headquarters last month when results came in from a study showing the company’s most important product, anti-cholesterol drug Crestor, failed to differentiate itself significantly from its top rival, Pfizer Inc.’s Lipitor.

Lipitor’s U.S. patent expires next month. So, cheap copies of Lipitor, a $12 billion-a-year seller, are expected to hit the key U.S. market at the end of November and in Europe next year, making competition in an already tough market heat up sharply—a prospect that deeply worries AstraZeneca.

The British company took a gamble by launching and funding a head-to-head study between the two powerful cholesterol drugs, hoping to make Crestor stand out from the crowd once Lipitor goes generic.

But the gamble seems to have backfired.

Saturn’s imaging tests showed that although patients on Crestor had a lower rate of artery-clogging plaque than those on Lipitor, the difference in that main goal wasn’t statistically significant. Crestor did show a significant improvement over Lipitor in a secondary endpoint, however.

With patents on many of its other drugs having expired or about to expire, AstraZeneca needs Crestor to keep growing strongly if it is to achieve its goal of $28-34 billion in annual group sales between 2010 and 2014.

As Bernstein analyst Tim Anderson said earlier this week: “If Saturn doesn’t show a clear benefit in favor of Crestor, payers could push back even harder against usage of the drug downstream of Lipitor generics.”

The Saturn study, initiated by the U.K. group, doesn’t seem to offer AstraZeneca much ammunition for that battle.

The company says views on Crestor’s efficacy versus Lipitor should not be based solely on this trial.

“Conclusions on the efficacy of Crestor should not be based on the Saturn study alone but on the wealth of data that exists on the safety and efficacy profile of the treatment,” a spokeswoman said.

“Crestor has been shown to be the most effective statin in terms of lowering (“bad”) LDL cholesterol and significantly raising (“good”) HDL cholesterol, particularly at higher doses in multiple randomised controlled trials without compromising tolerability,” she said.

Analysts say the jury on Crestor’s relative merits “may remain out” until full results from the Saturn trial are presented at the annual meeting of the American Heart Association Nov. 15.

http://blogs.wsj.com/source/2011/09...ot-yourself-in-the-foot/?mod=google_news_blog
 




The journalist (not a scientist) who wrote this does not understand statistics 101. A numerical difference that isn't statistically significant means the variance is due to chance. The numerical difference is not a reportable finding, the fact (the result) is that there is NO DIFFERENCE. He should not muddy the water by reporting the numerical difference, it makes it look like there is a difference. There is not.
 




The journalist (not a scientist) who wrote this does not understand statistics 101. A numerical difference that isn't statistically significant means the variance is due to chance. The numerical difference is not a reportable finding, the fact (the result) is that there is NO DIFFERENCE. He should not muddy the water by reporting the numerical difference, it makes it look like there is a difference. There is not.

The difference MAY be due to chance. Are you going to gamble with your heart? I bet you buy genuine GM parts though for your car, you dope
 




The difference MAY be due to chance. Are you going to gamble with your heart? I bet you buy genuine GM parts though for your car, you dope


The Saturn trial showed no benefit in Crestor over Lipitor. Statins provide questionable benefit for most when considering NNT, so there is effectively no difference. Also, many can't tolerate Crestor because it is so potent. Your argument does not fly. Goodbye.

http://www.businessweek.com/magazine/content/08_04/b4068052092994.htm

The second crucial point is hiding in plain sight in Pfizer's own Lipitor newspaper ad. The dramatic 36% figure has an asterisk. Read the smaller type. It says: "That means in a large clinical study, 3% of patients taking a sugar pill or placebo had a heart attack compared to 2% of patients taking Lipitor."

Now do some simple math. The numbers in that sentence mean that for every 100 people in the trial, which lasted 3 1/3 years, three people on placebos and two people on Lipitor had heart attacks. The difference credited to the drug? One fewer heart attack per 100 people. So to spare one person a heart attack, 100 people had to take Lipitor for more than three years. The other 99 got no measurable benefit. Or to put it in terms of a little-known but useful statistic, the number needed to treat (or NNT) for one person to benefit is 100.
 




The Saturn trial showed no benefit in Crestor over Lipitor. Statins provide questionable benefit for most when considering NNT, so there is effectively no difference. Also, many can't tolerate Crestor because it is so potent. Your argument does not fly. Goodbye.

http://www.businessweek.com/magazine/content/08_04/b4068052092994.htm

The second crucial point is hiding in plain sight in Pfizer's own Lipitor newspaper ad. The dramatic 36% figure has an asterisk. Read the smaller type. It says: "That means in a large clinical study, 3% of patients taking a sugar pill or placebo had a heart attack compared to 2% of patients taking Lipitor."

Now do some simple math. The numbers in that sentence mean that for every 100 people in the trial, which lasted 3 1/3 years, three people on placebos and two people on Lipitor had heart attacks. The difference credited to the drug? One fewer heart attack per 100 people. So to spare one person a heart attack, 100 people had to take Lipitor for more than three years. The other 99 got no measurable benefit. Or to put it in terms of a little-known but useful statistic, the number needed to treat (or NNT) for one person to benefit is 100.

I hope I am the one in 100, and you one of the 99.
 








Nortin M. Hadler, professor of medicine at the University of North Carolina at Chapel Hill and a longtime drug industry critic. "Anything over an NNT of 50 is worse than a lottery ticket; there may be no winners," he argues. Several recent scientific papers peg the NNT for statins at 250 and up for lower-risk patients, even if they take it for five years or more. "What if you put 250 people in a room and told them they would each pay $1,000 a year for a drug they would have to take every day, that many would get diarrhea and muscle pain, and that 249 would have no benefit? And that they could do just as well by exercising? How many would take that?" asks drug industry critic Dr. Jerome R. Hoffman, professor of clinical medicine at the University of California at Los Angeles.
 




The difference MAY be due to chance. Are you going to gamble with your heart? I bet you buy genuine GM parts though for your car, you dope

Is this what scientific studies discover? The possibility? Is that how you'll present this to a doctor:

Hey who knows, doctor -- it may help! It may not, and many times we've found that it can really really hurt and the drug gets removed from the market. But it may help.
 




Nortin M. Hadler, professor of medicine at the University of North Carolina at Chapel Hill and a longtime drug industry critic. "Anything over an NNT of 50 is worse than a lottery ticket; there may be no winners," he argues. Several recent scientific papers peg the NNT for statins at 250 and up for lower-risk patients, even if they take it for five years or more. "What if you put 250 people in a room and told them they would each pay $1,000 a year for a drug they would have to take every day, that many would get diarrhea and muscle pain, and that 249 would have no benefit? And that they could do just as well by exercising? How many would take that?" asks drug industry critic Dr. Jerome R. Hoffman, professor of clinical medicine at the University of California at Los Angeles.

When you are laying on the bathroom floor with pain running through your chest and arm and someone offered you a one 1 in 250 chance to live what would you say for f'ing moron.
 




All of this will be ancient history where half of you are laid of next year. Generic Lipitor will rule, just like generic Plavix will rule, just like generic Seroquel will rule. It will all be over in a few months. Are you prepared?
 




hey...our marketing message for Crestor when it came out in 2003 was...
"Ride the Wave" a person on a surf board. Are you kidding me. Take a serious disease and link it to surfing...100% wrong....of course unless it's a Tidal Wave....which is about to happen. Get ready for more spreadsheets and telelconferences on how to sell against a generic Lipitor...losers all losers at AZ!!
 
















When you are laying on the bathroom floor with pain running through your chest and arm and someone offered you a one 1 in 250 chance to live what would you say for f'ing moron.

"Thank God I saved all that money by taking generic. Now I can afford my copay for this hospital stay!!"

"I think I'd better tell my doctor to quit giving me all those free Crestor samples."

and my personal favorite: "Dammit, I gotta quit watching all those damn drug company DTC commercials."
 




"Thank God I saved all that money by taking generic. Now I can afford my copay for this hospital stay!!"

"I think I'd better tell my doctor to quit giving me all those free Crestor samples."

and my personal favorite: "Dammit, I gotta quit watching all those damn drug company DTC commercials."

You sound like a great salesman. I'm sure the doctors like your scientific approach. Not. Scare tactics work better. How about, my generic Lipitor works as well and is much cheaper than Crestor. Enjoy trying to find a sales job with your technique.
 




"Thank God I saved all that money by taking generic. Now I can afford my copay for this hospital stay!!"

"I think I'd better tell my doctor to quit giving me all those free Crestor samples."

and my personal favorite: "Dammit, I gotta quit watching all those damn drug company DTC commercials."

Thank God I woke up and quit eating french fries and nachos for dinner every night. Thank God I drank some OJ and went to the gym, and quit smoking. And thank God I didn't take the medicine the doctors were shoving down my throat and started being responsible for my own life and well being, instead of hoping that a little pill would solve my problems.

Thank God I looked at all of the drugs out there that were promised to be safe and then later pulled from the market because they are effectively poison.
 




Maybe all of the fat out of shape slobs taking these drugs should get a f'in gym membership instead of relying on an overpriced pill. I asked my GP to put me on freaking lovastatin and combined with workout dropped 40 points in my total cholesterol #. Dropped in some added resveratrol and and q.d. fish oil and it went even lower. Maybe I should try some f'ing Quaker Oats or Cheerios next!
 




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